Environ. Sci. Technol., Publication Date (Web): January 12, 2012
Freshwater availability and water fetching distance affect child health in Sub-Saharan Africa
Amy Janel Pickering and Jennifer Davis
Currently more than two-thirds of the population in Africa must leave their home to fetch water for drinking and domestic use. The time burden of water fetching has been suggested to influence volume of water collected by households as well as time spent on income generating activities and child care. However, little is known about the potential health benefits of reducing water fetching distances. Data from almost 200,000 Demographic and Health Surveys carried out in 26 countries were used to assess the relationship between household walk time to water source and child health outcomes. To estimate the causal effect of decreased water fetching time on health, geographic variation in freshwater availability was employed as an instrumental variable for one-way walk time to water source in a two-stage regression model.
Time spent walking to a household’s main water source was found to be a significant determinant of under-five child health. A 15-minute decrease in one-way walk time to water source is associated with a 41% average relative reduction in diarrhea prevalence, improved anthropometric indicators of child nutritional status, and a 11% relative reduction in under-five child mortality. These results suggest that reducing the time cost of fetching water should be a priority for water infrastructure investments in Africa. Furthermore, the health burden of water fetching borne by African children may increase in the next several decades, as climate change and growing urban populations continue to reduce per capita freshwater availability in sub-Saharan Africa.